title: Importance of symptomatic cerebral infarcts on cognitive performance in patients with Alzheimer's disease.
abstract: The coexistence of cerebral infarcts and Alzheimer's disease (AD) is common, but the influence of symptomatic cerebral infarcts on cognition is uncertain in AD. We hypothesize that symptomatic cerebral infarcts may provide an additive cognitive factor contributing to dementia in the AD population. We studied 1,001 clinically probable or possible AD patients in the Alzheimer Disease Research Center (ADRC) database. Linear regression was used to evaluate for an association between symptomatic cerebral infarcts and memory, language, executive function, abstract reasoning, and visuospatial performance, separately. Models were adjusted for covariates including age, gender, education, ethnicity, hypertension, diabetes mellitus, heart disease, clinical dementia rating, the presence of silent cerebral infarcts, and multiplicity or location of infarcts. Clinical history of stroke was present in 107 patients, radiological infarcts in 308 patients, and 68 patients with both were considered to have symptomatic infarcts. Adjusting for all covariates, AD patients with symptomatic infarcts had more impairment of executive function (P < 0.05). The influence of cerebral infarcts is neither general nor diffuse, and the presence of clinical history may have a more important influence on executive performance in AD.
authors.affiliation: Department of Neurology, Hangang Sacred Heart Hospital, Hallym University College of Medicine, 12 Beodnamu-ro 7-gil, Seoul, Korea. dowonc@naver.com
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Cho
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Scarmeas
authors.forename: Tae-Won
authors.initials: TW
authors.lastname: Jang
authors.forename: Karen
authors.initials: K
authors.lastname: Marder
authors.forename: Ming-Xin
authors.initials: MX
authors.lastname: Tang
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Honig
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology*; D002544:Cerebral Infarction / Q000503:physiopathology*; D003072:Cognition Disorders / Q000503:physiopathology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020521:Stroke